Culture of Health

This Spotlight is a part of a special blog series by the Case Foundation featuringBe Fearlessstories from the field. Follow along with us as we meet people and learn about organizations that are taking risks, being bold and failing forward in their efforts to create transformative change in the social sector. This Spotlight is authored by Karabi Acharya (@KarabiGlobal), Director of Global Ideas for U.S. Solutions at Robert Wood Johnson Foundation.

Being fearless means imagining the “impossible.” Martin Luther King, Jr. asked us to imagine the impossible when he asked for a world where his children would be judged by the content of their character and not by the color of their skin. Harriet Tubman, the slavery abolitionist, spoke about how her capacity to imagine the impossible guided her in her fight, “Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience and the passion to reach for the stars to change the world.” And Anne Kronenberg—Harvey Milk’s campaign manager—has said of the gay rights leader, “He imagined a righteous world inside his head and then he set about to create it for real, for all of us.” Imagining a different world is the first step toward building a different world.

My colleagues at the Robert Wood Johnson Foundation (RWJF) and I ask ourselves every day to imagine something that some may believe is out of reach: a Culture of Health in this country. In a Culture of Health, being as healthy as you can be is part of everything we do as a society. In a Culture of Health, we define being healthy as more than not being sick. And, in a Culture of Health, we support practices and policies that address the excessive influence that income, education, ethnicity and even a zip code has on Americans’ health and wellbeing. We don’t think we can do it alone—so we’re asking others to join us—and we are not adhering to a rigid blueprint to guide us. Instead, we are allowing ourselves to be open to emerging strategies that we discover along our path to ensuring everyone is able to live the healthiest life possible.

It’s a shift for us. We’re moving away from the traditional 18-month strategic planning process and toward the belief that the strategies to achieve our vision will emerge as we proceed—fearlessly. This new, fearless direction—reflected in the Case Foundation’s Be Fearless principles—is a decision to not just reach beyond our bubble, but to burst it wide open. As one of the largest foundations in the U.S. and the largest dedicated to domestic health, we’re often encouraged to speak up and lead. But we’re putting ourselves in rooms with people and organizations that have no idea who we are and building unlikely partnerships, where our only purpose is to listen and learn.

My work at RWJF is to lead a team of colleagues to identify and learn from countries around the globe that have already achieved or are making notable progress toward building a Culture of Health. We’re looking at countries that have stopped defining health as simply not being sick—and the policies and practices reflect this knowledge. We’re looking at higher-income countries like Denmark, where primary care physicians actively coordinate the care of their patients, and a sophisticated electronic health record (EHR) system contributes to this effective coordination, as well as better outcomes and improved quality. We’re looking at countries like Wales where data and collaboration are serving as effective deterrents to violence. We’re looking at the Netherlands to see what they are doing in response to the link between climate change and health equity. We’re looking at Singapore, where they are better positioned to contend with an aging population than we are by acknowledging it, experiencing the consequences and making efforts to mitigate them. And we’re looking at middle- and lower-income countries as well. We’re looking at Cuba, for example, where the emphasis on prevention and primary care, community-level clinics and a low physician-patient ratio leads to outcomes that rival most high-income countries, including our own.

We understand that innovation happens at intersections, and we aren’t going it alone. We’re learning from the successes and failures of others, and finding the best and most innovative solutions.

But it’s much more than looking for powerful models or best practices that we can bring to the U.S. Actively learning from other countries unleashes our collective imagination. It provides us—and our partners—with the inspiration we need to make our way along the difficult and long path toward the kind of world in which we want to live. We can better imagine what a Culture of Health will look like by seeing it in practice.

An Invitation to Be Fearless

There are a few ways we hope the Be Fearless community can join us and help us to continue to imagine the possibilities. First, if there’s someone with whom we should be speaking, please let us know. Secondly, if you have stories of ideas or approaches that have come from abroad and taken root, we want to hear them. We believe strongly in the value of a global perspective and want to strengthen this argument by collecting and sharing examples. Thirdly, if there are events that we should be attending in the U.S. or overseas that would expose us to the kinds of ideas we’ve described here or the people we want to meet, please share your recommendations. For all of these, please email us at globalideas@rwjf.org.

Finally, we recently launched our first call for ideas, which is open through May 31, 2016. We are looking for projects, programs and models from other countries that promote a Culture of Health with a commitment to equity. We’re looking for applicants who represent organizations from a wide range of fields and disciplines—both within and outside the health sector. We will support grants from $50,000 up to $250,000 (USD), for up to 18 months. If you have an idea you’d like to share, we encourage you to check out our website for more information.